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Xenogeneic Donkey-In-Horse Pregnancy Created by Embryo Transfer
Published in Gérard Chaouat, The Immunology of the Fetus, 2020
W. R. Allen, Julia H. Kydd, D. F. Antczak
The coincidental appearance of alloantibody in maternal serum and endometrial cup development suggests the invading chorionic girdle cells as the likely source of paternally derived ELA antigens. Consistent with this is the intense staining of preinvaded chorionic girdle tissue in an indirect immunoperoxidase labeling system when reacted with high-titer and paternal-specific alloantisera generated by skin-grafting, followed by pregnancy established by the skin-graft donor.39
Immunohematology
Published in Gabriel Virella, Medical Immunology, 2019
Gabriel Virella, Armand Glassman
Blood transfusions may be necessary in emergency situations but are made difficult when there are autoantibodies to red cell antigens widely represented in the population. The serum from a patient with cold or warm-type AIHA typically agglutinates all the red cells in an antibody identification panel. It is most important to determine if there are clinically significant underlying alloantibodies that may be masked by autoantibody. The patient's red cells may be pretreated in a manner to enhance removal of autoantibody from the serum. After one or more autoadsorptions the adsorbed serum may be used for alloantibody detection and crossmatching.
Immune Hemolytic Anemias
Published in Harold R. Schumacher, William A. Rock, Sanford A. Stass, Handbook of Hematologic Pathology, 2019
Joseph P. Yoe, Ronald A. Sacher
Hemolysis that does not immediately follow transfusion presents a diagnostic problem. Findings may range from a less than expected rise in hemoglobin to an obvious hemolytic transfusion reaction (fever, chills, hemoglobinuria), as with anti-Kidd antibodies. The occurrence of delayed hemolytic transfusion reactions has been observed up to 3 weeks posttransfusion. These findings are the result of an anamnestic immune response in a patient already primarily immunized to a specific blood cell antigen. The delayed transfusion reaction is indicated by: An antecedent transfusionA mixed-field agglutination of the direct antiglobulin testDetection of a new alloantibody
Investigational drugs for the treatment of kidney transplant rejection
Published in Expert Opinion on Investigational Drugs, 2022
Lukas K van Vugt, Maaike R Schagen, Annelies de Weerd, Marlies EJ Reinders, Brenda CM de Winter, Dennis A Hesselink
In transplant rejection, B lymphocytes play a versatile role. They can differentiate into (donor-specific) antibody-secreting plasma cells and influence the T lymphocyte response by acting as antigen presenting cells (APC) and through the production of cytokines [19]. Because of the central role of B lymphocytes and donor-specific anti-HLA antibodies (DSA) in ABMR, rituximab has been investigated extensively for this indication. In a murine transplantation model, repeated doses of rituximab reduced alloantibody formation against donor splenic cells and prolonged graft survival independent of antibody-secretion, suggesting rituximab inhibited both antibody-mediated and antibody-independent rejection mechanisms [20]. In human kidney transplantation, rituximab was effective in reducing blood group antibodies in blood group-incompatible transplantation and in reducing the concentration of DSA in highly immunized recipients [21]. However, rituximab was not effective in preventing TCMR when prescribed as an induction agent [22].
Exploring the rationale for red cell transfusion in myelodysplastic syndrome patients: emerging data and future insights
Published in Expert Review of Hematology, 2022
Carlo Finelli, Sarah Parisi, Stefania Paolini
The rate of anti-RBC alloimmunization in TD MDS patients is not significantly different compared to other polytransfused patients [28], and ranges from 11% to 57%, according to the transfusion modalities (prophylactic matching or not) [29]. The cumulative incidence of alloimmunization increases in relation to the load of RBC units, and in most cases the Rh or Kell antigens are involved. The appearance of alloantibodies may be associated with an increase in transfusion requirement, and can be followed by an increase in transfusion intensity, while its incidence seems to be decreased following the administration of disease modifying therapies (HMAs). Also, severe delayed hemolytic transfusion reactions may rarely occur [30,31,33]. A variable percentage (3,6–10%) of TD MDS patients may also develop autoantibodies (more frequent in alloimmunized subjects), with a positive direct antiglobulin test (DAT), which can be associated with clinically significant autoimmune hemolysis, and consequent shortened RBC survival and increase of transfusion intensity. The pathogenetic mechanism of the onset of alloimmunization following alloimmunization has not yet been elucidated, although a failure to regulate alloantibody-induced lymphoproliferation has been hypothesized [30,33].
Thalassemia in Indonesia
Published in Hemoglobin, 2022
Pustika A. Wahidiyat, Teny T. Sari, Ludi D. Rahmartani, Stephen D. Iskandar, Anastasia M. Pratanata, Ivana Yapiy, Iswari Setianingsih, Tubagus D. Atmakusuma, Anna M. Lubis
Every single unit of blood that has been transfused carries a small but definite risk of both infection transmission and transfusion reaction [23]. These risks multiply when joined with chronic transfusion treatments that are life-long and could be as frequent as once every 2 weeks. Repeated blood exposure may also induce alloantibody formation that will hinder finding suitable blood donors, which subsequently increase the risks even more [24]. Dramatic improvement has been made on preventive measures against pathogens ever since the introduction of nucleic acid testing in 2015. As can be seen in Figure 1, the incidence of blood-borne infections has fallen remarkably since nucleic acid screening was implemented. Nevertheless, this fairly sophisticated technique is limited to a handful of large urban centers such as Jakarta, Surabaya, Bandung. A study conducted at Semarang, Indonesia [25], showed that the prevalence of the hepatitis B virus (HBV) was 1.5% and 0.5% for HIV from 400 blood donors checked, reinforcing the need for a sensitive method against blood-borne pathogens. However, there is a paucity of data, however, on the prevalence of transfusion-transmitted infection among thalassemia patients across Indonesia.